Abstract

BACKGROUND:

Genetic, physiological, and psychological factors can affect food intake, but twin studies can distinguish inherited from environmental contributors. We examined the influence of attempted cognitive control of eating ("restrained eating") on levels of appetite-regulating hormones.

METHODS:

Sixteen female, monozygotic twin pairs, discordant for Restraint Scale score (i.e., one twin a restrained eater with score>15 whereas the co-twin was unrestrained), were selected from the University of Washington Twin Registry. Serial plasma ghrelin concentrations were monitored during meals and a preload study paradigm involving intake of a milkshake followed by an ad libitum ice cream "taste test."

RESULTS:

Body weight, body mass index, resting energy expenditure, and fasting leptin levels were very similar between restrained and unrestrained twins. In a preload study, twins ate similar amounts of ice cream shortly after drinking identical milkshakes (mean±SD; restrained 239±158 vs. unrestrained 228±132kcal; P=0.83). However, ghrelin concentrations during the preload study were significantly higher (P=0.03) in restrained twins than in their unrestrained co-twins. Regardless of restraint status, ghrelin levels prior to the preload study were prospectively and positively associated with ice cream intake (P=0.001).

CONCLUSIONS:

Compared to their unrestrained co-twins, restrained twins had higher endogenous ghrelin levels during a preload study, but ate similar amounts. This finding is consistent with exertion of cognitive control relative to the state of physiologic appetite stimulation. Moreover, these findings in twins suggest that higher ghrelin levels result from restrained eating behavior and not from genetic predisposition.

Mean (SEM) total ghrelin concentrations in unrestrained vs. restrained twins across time. Breakfast beverages were matched between twins and also were isocaloric with the milkshake served during the preload study. Beverages were labeled either “low-calorie breakfast drink” or “milkshake.” Caloric intake during the preload study's ad libitum ice cream taste test (which followed ingestion of identical milkshakes) was not significantly different between unrestrained and restrained eating twins. Group differences in ghrelin concentrations during breakfast (NS, P=0.09) and during the preload study (*P=0.03) were tested by using generalized estimating equations. Abbreviation: pg/ml = picograms per milliliter, ad lib = ad libitum, NS = not significant.

Higher total ghrelin concentrations are associated with greater ad libitum ice cream intake. Noon plasma samples were taken just prior to the preload study. Ice cream was offered ad libitum as a taste test following consumption of a standardized milkshake. Abbreviations: pg/ml = picograms per milliliter.